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Caren is the daughter of Kirei Kotomine and Claudia Hortensia. Her mother, who was very sickly, killed herself in a final attempt to help Kirei, who was on the verge of suicide due to his inherently twisted nature, feel he deserved to live. It did not work, and rather than caring for Caren himself, he placed her in the custody of her mother's relatives, thus having her take up their surname. She eventually became a priestess in the Church. Despite being active in the same organization, she never encountered her father in any official capacity.[2]

She was sent to Fuyuki by the Church to replace Kirei after his death and report the aftermath of the Fifth Holy Grail War.

Caren takes after her mother, Claudia, having light grey hair and golden eyes. Due to her demon detecting abilities, she is nearly always covered in bandages. She is usually seen wearing church robes, and a hat if she is outdoors. On the other hand, Caren also wears what she calls her "exorcist uniform" which is composed of a dress and stockings over pantyhose, but without a skirt. She claims that she has removed the skirt to both increase her mobility and to seduce men.

As a priestess, Caren Hortensia exhibits an outwardly accepting personality, but she is not entirely angelic. Her current position simply suits her physiological characteristics. Outside of fulfilling her job, she will readily provoke acquaintances and display outright sadism to those close to her.

It can be said that her life's purpose is to help others at any cost, and she carries that out to the point of inflicting self-harm and deferring any blame to the demonic influence driving her attackers. She will frequently apologize to God, for both her own faults and those who slight her.

Because of this twisted personality, even her two servants are wary of her, both maintaining great distance at all times even without the threat of Command Spells. For going against her would mean having their power turned against them without a second thought for their mutually assured destruction.

While she is described as "the mouthpiece for Kotomine's personality" due to her callous wit, she still inherits significant feminine charm from her mother, making her a largely affable person despite the wealth of acerbic remarks issuing from her lips.

Caren serves an objective mediator in the false Holy Grail War created by Avenger and Bazett Fraga McRemitz and, in the place of the absent Kirei Kotomine, as the Master of Lancer and Gilgamesh. Because she was not present in the previous war, she is not affected by the four day time loop like the others are.

During Hollow ataraxia, Shirou Emiya finds that each time he runs into Caren, he dies. Eventually, Shirou ends up defending Caren from the dark creatures that have appeared since the time loop began. He is finally able to meet her without dying, but finds that he is experiencing strange feelings of anger and hatred and not acting like himself.

Shirou is eventually revealed to be an imposter or in the very least, not completely himself; he is actually Avenger in the guise of Shirou (the real one is either not present in the game, or being possessed by Avenger). She continues to offer advice to him, perhaps knowing his true identity(s) all along. She and Avenger develop intimate feelings for each other.

In spite of this, or perhaps because of it, Avenger has Caren participate in a painful sexual episode with him, with Caren trying to conceive Avenger's child during the event. Avenger himself is wryly amused by this, declaring that there should only be one of him.

It is also revealed that the woman who finds Bazett and nurses her back to health is Caren.

Caren and Bazett are last shown in a bonus scene with the real Shirou, with Bazett taking residence at Shirou's house, much to the annoyance of the women in Shirou's life.

She appears as herself and as her alter-ego, Magical Caren (マジカルカレン, Majikaru Karen?). She gets to meet her father, who quickly remarks that while Caren looks physically like her mother, she is just like her father in terms of personality.

Caren initially makes minor appearances in Carnival Phantasm, but gets a major role in the EX episode. After Caren gets some money in an illegal job, she attempts to control the world using money with varying degrees of success.

Her trolling and abusive personality is comically exaggerated and Lancer and Gilgamesh often remark that she is just like her father Kirei.

She is the school nurse in Homurahara elementary. She has been observing Illyasviel von Einzbern, Miyu Edelfelt and Chloe von Einzbern. She displays absolutely no interest in the events, and she is rather carefree about her job as a nurse. She is later revealed to be the Church's representative in the affair related to the Class Card, working as background support as well as supervisor. It is also revealed that she chose to work as a school nurse as it allows her to indulge in her interest in observing the sufferings of children close up.

In Capsule Servant, she only appears in the true ending route. Both Shirou and Rin encounter little Caren in her own world, she is also known as Baby Caren or Caren-chan. She is the world-observing baby chosen by the Great Grail to gaze down on the world in amusement and she was the reason Capsule Servant was created. The grail is nothing more than the negative thoughts of people. She used the power of the Grail to create a world in which every character's worth decreases. All the boss characters were cursed to be disappointing but they didn't change much especially TOHSAKA. She reveals to Rin and Shirou about her involvement and she claims that she is doing this just to show her benevolence towards them. She finds it was entertaining to watch them fighting amongst themselves with the Capsule Servants she prepared.[3]

After she was defeated, Caren decided that the world should be destroyed as this world is so cruel to children. The world starts to self-destruct leaving a worm hole portal exit for Rin and Shirou. The destruction on the Grail will be dragged into the spiral of worthlessness and will make the real world return to its original state. Against Caren's wishes, Shirou decided to save Caren because Shirou thought it was pitiful for Caren to disappear like that and that he is a Hero of Justice. Caren accepted Shirou offer to be raised as the Emiya family's baby. Shirou adopted Little Caren and apparently she's listed on the family register as Taiga's daughter. In the end, it is revealed that it was Caren who wrote Capsule Servant plot.[3]

As a member of the Church, Caren assists in exorcisms. Although her father has Magic Circuits, she didn't inherit them, but she did inherit her mother's "proneness to be plagued by illnesses", much like an ordeal given by God.[4] Her body itself possesses an unusual property which is known as Masochistic Pneumatic Automatism Diathesis; if there is a person nearby who has been possessed by a daemon, her body will mimic the end effects that the daemon possession will eventually have on the possessed human. As a result, exorcists employ her to act as a radar of sorts to find daemons. This ability cannot be gained from training since it is purely genetic, which is why people born with these traits are valued by the Church as demon detectors.

This ability is most evident whenever she comes in proximity to the Servant Avenger as her body begins producing a Shade by sprouting grotesque spikes from inside her body.

She owns the Holy Shroud, the Shroud of Magdalene (マグダラの聖骸布, Magudara no Seigaifu?), which is a red cloth with the power to forcefully bind men. However, while the man is bound, no harmful physical attacks can be made against him or Magdalene will be rendered useless. It is a type of Mystic Code. In Carnival Phantasm she puts its inherent properties to work separating baby chickens by sex in exchange for cash.

She was to originally be a character developed for the potential Tsukihime 2 along with Bazett, but she was redesigned for Fate instead. The character present with Mr. Dawn in Prelude has an ability very similar to her.

[v] TYPE-MOON Fes.Official Pamphlet 10th Anniversary Q & A Booklet:Q: Kirei's wife Ortensia is covered with wounds in the design draft, is it because she has a body similar to Caren's? Also, Command Spells appeared on Kirei due to the fact that he somehow possesses Magic Circuits despite being born in a non-magus lineage. Does this mean Caren also has Magic Circuits?

Q: Kirei's wife Ortensia is covered with wounds in the design draft, is it because she has a body similar to Caren's? Also, Command Spells appeared on Kirei due to the fact that he somehow possesses Magic Circuits despite being born in a non-magus lineage. Does this mean Caren also has Magic Circuits?

A: Kirei's wife is an albino, and is immunodeficient. As a result, she can die from even a tiny wound, thus her body appears tattered. What Caren inherited is the aspect of "prone to be plagued by illnesses". This is truly an ordeal given by God.About the Magic Circuits, a normal person rarely acquires Magic Circuits. You can consider such cases sudden mutations. However, Kirei is not of this type. Kirei's Circuits were a gift from the divine sacrament, rewarding his father Risei's years of pious worship. Kirei was born with "the right to recreate the miracles in the divine sacrament". This "right", in other words, was the Magic Circuits. Caren did not inherit the Circuits.